Associated Team

ToFMOD: Predictive modeling for tetralogy of Fallot patients 

  • ToFMOD is an Inria Associated Team funded by Inria France and Pediatric Cardiac MR Imaging Lab of UT Southwestern Medical Center Dallas (UTSW) and formed by researchers from the M3DISIM team (Inria Saclay), UTSW Medical Center Dallas and additional participants from MRI and cardiology departments (London, Prague, Sevilla).
  • The aim of ToFMOD team is to address various issues in patients with repaired Tetralogy of Fallot (rToF) by including biomechanical modeling, i.e. adding physics and physiology into the loop of clinical exams and management.
  • In rToFs we identified problems of optimal timing of intervention as e.g. a pulmonary valve replacement therapy (PVR) or branch pulmonary artery (PA) stenting. In addition, we would like to increase understanding of failing of LV in what-is-classicaly-known to be an "RV disease", as rToF patients are known to develop LV failure earlier than the general population.
  • While tackling the cohort of rToF patients - i.e. a typical disease of right ventricle (RV), RV outflow tract (RVOT) including pulmonary valve, and branch pulmonary arteries (PA's) - the methods are in essence more universal and we are in fact exploring their applicability between LV & RV, pulmonary & aortic valve, and pulmonary artery & aorta.
  • These leads to three main objectives of ToFMOD:
    1. Ventricular mechanics and its biomechanical modeling: aiming to optimize the timing of PVR
    2. Ventricular motion characterization augmented by modeling
    3. Characterizing the flow through pathological valve by using fluid mechanics aiming to optimize the timing of branch-PA stenting
  • PVR is the therapy of choice in volume-overloaded RV due to insufficient pulmonary valve. The dilated RV may even shrink back to normal size, if the PVR is performed "not too late". The lifespan of the replaced pulmonary valve is typically 5-10 years, i.e. the rToF patients need several re-interventions during their life. Therefore, the PVR procedure tends to be postponed to "as late as possible", however prior to an irreversibility of the RV dilatation or other adverse effects occur.
  • Branch PA stenosis is typically managed by stenting. The timing of re-stenting is however not clear, and assessing the already stented artery by magnetic resonance imaging may be challenging due to artifacts caused by the stent. Couplling of image data with a model has the potential to augment the information from clinical exam.

Members of theToFMOD Associated Team

Events

  • 25 August 2020: TOFMOD 2020 workshop, as a satellite event of the VPH2020 conference, will take place in Paris.
  • Journal paper on Model-augmented monitoring of cardiovascular physiology during general anesthesia was published in PLOS ONE (a part of TOFMOD objectives #1 and details are available in M3DISIM news).
  • Journal paper on Non-rigid registration of image series to map myocardial fibrosis, in the scope of ToFMOD associated team was accepted for publicaton in Series S of Discrete and Continuous Dynamical Systems (preprint available via HAL). The work is a part of ToFMOD objectives #2 (model-constrained image processing). The details are available on M3DISIM news.
  • Journal paper on coupling between modeling of large vessel flow and magnetic resonance imaging was published in Magnetic Resonance Materials in Physics, Biology and Medicine. The work is part of ToFMOD objectives #3 and details are available in M3DISIM news.
  • Journal paper on Fontan circulation modeling was published in PLOS ONE. The work is part of ToFMOD objectives #1 and details are available in M3DISIM news.
  • Co-organization of Doctoral School Modeling of Biomaterials , February 10-16 2020. Various aspects of TOF modeling, as well as interactions between medicine and mathematics were discussed.
  • 4-7 November 2019: Visit of R. Chabiniok & T. Hussain (via telco from Dallas) at IKEM and Czech Technical University and Charles University in Prague while discussing on modeling for large-vessel flow (ToFMOD objectives #3).
  • 14-18 October 2019: Visit of R. Chabiniok at UTSW Medical Center Dallas, discussing the ToFMOD projects and official interviews of R. Chabiniok to joint UTSW team in 2020 and work on ToFMOD objectives #1-3 while being (mostly) affiliated in the clinical team.
  • 23-26 June 2019: Visit of T. Hussain at Inria Saclay to discuss the ToFMOD projects (ToFMOD objectives #1-3)
  • 10-21 June 2019: A project implementing motion tracking tool developed by M. Genet directly at Children's hospital, UTSW Medica Center Dallas  (visit of UTSW by R. Chabiniok and K. Skardova, while M. Genet joined by daily teleconferences), ToFMOD objective #2. As one outcome of the work is an abstract accepted to SCMR (world main conference of Cardiovascular Magnetic Resonance imaging): D.A. Castellanos, K. Skardova (Solovska), A. Bhattaru, G. Greil, A. Tandon, J. Dillenbeck, B. Burkhardt, T. Hussain, M. Genet, R. Chabiniok: Left ventricular torsion obtained using equilibrated warping in patients with repaired Tetralogy of Fallot & journal paper is currently in preparation.
  • Conference paper supported by ToFMOD K. Skardova (Solovska), M. Rambausek, R. Chabiniok, M. Genet: Mechanical and Imaging Models-based Image Registration, Proc. of VipIMAGE 2019, Volume 34 of Lecture Notes in Computational Vision and Biomechanics, pp. 77-85, Springer, Cham, was presented by M. Genet at VipIMAGE2019 conference in Porto, ToFMOD objective #2.
  • Conference paper supported by ToFMOD   B. Ruijsink, K. Zugaj, K. Pushparajah, R. Chabiniok: Model-based indices of early-stage cardiovascular failure and its therapeutic management in Fontan patients, Proc. FIMH  2019, was presented at Functional Imaging and Modelling of Heart Conference (May 2019), ToFMOD objective #1.
  • 6-10 May 2019: Visit of R. Chabiniok at UTSW Medical Center Dallas, followed by R. Chabiniok and T. Hussain joining Annual meeting of International Society of Magnetic Resonance in Medicine (ISMRM) in Montreal, where presenting ToFMOD objective #1
  • 7-18 January 2019: Visit of K. Solovska (Skardova) at Inria Saclay, leading to submitting a conference paper "K. Solovska, et al: Mechanical and Imaging Models-based Image Registration, VipIMAGE 2019 conference (Porto, Portugal)", ToFMOD objective #2.
  • 17 Decemeber 2018: R. Chabiniok invited to give a seminar at Children's Heart Center, University Hospital Motol, Prague, Czech Republic (by Prof. J. Janousek), interaction of ToFMOD with Children't Heart Centre in Prague was discussed
  • 5-10 October 2018: visit of Animesh (Aashoo) Tandon from UTSW Dallas at Inria Saclay (discussions in the PhD project of M. Gusseva, and new clinical data of teralogy of Flalot patients from UTSW Dallas, and University of Austin)
  • 19 September 2018: R. Chabiniok invited to give a whole-institute seminar at Institution for Clinical and Experimental Medicine, IKEM Prague, Czech Republic on Clinical applications of cardiac modelling (including the topic of ToF modelling)
  • 1-30 August 2018: summer internship of K. Solovska (associated partner institute from Prague) working with M. Genet and R. Chabiniok on model-based motion extraction from CMR images
  • 21 June 2018: Presenting ToFMOD at World Congres of Biomechanics, WCB 2018, Dublin, Ireland
  • 22 June 2018: ToFMOD MRI & Modeling workshop 2018, Inria Saclay Ile-de-France
  • 20 June 2018: Presenting ToFMOD at main world clinical conference on magnetic resonance imaging in medicine ISMRM 2018, Paris, France
  • 1 November 2017: launching a PhD of Maria Gusseva jointly supervised between Inria (R. Chabiniok and D. Chapelle) and UTSW Medical Center Dallas (T. Hussain)